Continuing Warfarin for 18 Months After Unprovoked PE Reduces Risk of Recurrent VTE


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Am Fam Physician. 2015 Nov 1;92(9):814.

Clinical Question

Does continuing warfarin (Coumadin) for 18 months after an unprovoked pulmonary embolism (PE) reduce the risk of recurrent venous thrombotic events?

Bottom Line

Continuing warfarin therapy for 18 months after an unprovoked PE reduces the risk of recurrent symptomatic venous thromboembolism (VTE). However, benefit beyond 18 months is not maintained after the warfarin is discontinued. (Level of Evidence = 1b)


Patients with unprovoked VTE have a higher risk of recurrence than those with a provoked event. This is the first study to evaluate extended anticoagulation beyond six months for patients with unprovoked PE. The authors enrolled adults (N = 371), 18 years or older, who received six months of therapy with a vitamin K antagonist f

POEMs (patient-oriented evidence that matters) are provided by EssentialEvidence Plus, a point-of-care clinical decision support system published by Wiley-Blackwell. For more information, please see http://www.essentialevidenceplus.com. Copyright Wiley-Blackwell. Used with permission.

For definitions of levels of evidence used in POEMs, see http://www.essentialevidenceplus.com/product/ebm_loe.cfm?show=oxford.

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This series is coordinated by Sumi Sexton, MD, Associate Deputy Editor.

A collection of POEMs published in AFP is available at http://www.aafp.org/afp/poems.


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